311561-3666Qazvin University of Medical Sciences181Health Care ManagementSocial capital and necessity for community based participatory researchAsefzadehS.1520061013502092008182PathologyA comparison on histopathological effects of Myrtle extract and silver sulfadiazine 1% on healing of second degree burn wound in rats JorsaraeiSGhMoghadamniaAAFiroozjahiA.MiriSM.OmraniradA.SaghebiR.HashemiST.15200610161502092008
Abstract
Background: Myrtle (Myrtus Communis) is an indigenous plant of northern parts of Iran and has been traditionally used for its healing effects on burn wounds.
Objective: To compare the histopathological effects of Myrtle extract and 1% silver sulfadiazine on healing of second degree burn wound in rats.
Methods: This was an experimental study performed on 100 adult male rats. The rats were divided into 4 groups (25 in each group). Following nesdonal anaesthesia, a second degree burn wound of 4 cm2 was made on back of each rat. Methanolic extract of Myrtle ointment base 1% silver sulfadiazine and normal saline (control group) were used as treatment protocols for burn wounds. Revascularization, number of neutrophils and fibroblasts were parameters studied histopathologically. Data were analyzed using Chi-square, Kruskal-Wallis, One way ANOVA and Tukey’s HSD tests.
Findings: Histopathological study was indicative of an increase of 9.87±1.48 in revascularization (p<0.001) in Myrtle extract group which was greater than those in others. There was also a higher number of fibroblasts (23.62±2.2) (p<0.001) in this group. Silver sulfadiazine (1%) was only shown to have increased the number of neutrophils (p<0.001) in epidermis of injured areas of rats.
Conclusion: Extract of Myrtus Communis was found to have more healing potential on second-degree burn wound. Faster healing process, less complications and easy availability of Myrtle are among the reasons suggesting more clinical trails using this preparation.
183CardiologyAssociation between macronutrients intake and cardiovascular risk factors in adults: Tehran Lipid and Glucose Study (TLGS)MirmiranP.AzadbakhtL.MehrabaniH.AziziF.152006101162302092008
Abstract
Background: Literature on independent relation between macronutrients intake and risk factors of cardiovascular disease is sparse.
Objective: To investigate the possibility of an independent relation between macronutrient intake and the risk of cardiovascular disease.
Methods: This was a cross sectional study performed on 243 participants of the TLGS study. Blood lipids, anthropometric indices and blood pressure were measured using standard protocols. A 24-hour dietary intake recall for two days was obtained. Logistic regression method was used to determine the relationship between cardiovascular risk factors and macronutrients intake.
Findings: The mean age of participants was 53±7 years. The men who consumed more carbohydrate had lower chances for hypercholestrolemia. Women with more lipid intake had lower chances for high LDL and hypertension. Individuals in third and fourth quartiles of protein intake had a lower odds ratio for high LDL and hypercholestrolemia in comparison to those in the first quartile.
Conclusion: Our data demonstrate an independent relation between some macronutrients intake and cardiovascular risk factors. In future studies, it is recommended that such a relationship to be investigated considering the effects of controlled physical activities.
185NutritionStudy of calories and macronutrients intake in people of Rasht and Qazvin AgheliN.AssefzadehS. RajabiM.GhoddousiA.152006101243002092008
Abstract
Background: A balanced nutrition is in direct association with health.
Objective: To compare calories and macronutrients intake in people from two areas of Rasht and Qazvin cities.
Methods: This cross sectional study was performed on 1100 persons over 30 years (cluster random) in Rasht and Qazvin in 2003. Dietary assessment was performed using a standard questionnaire. Student t-test and Pierson correlation were used for statistical analyses.
Findings: We found that a series of unhealthy food habits such as consumption of hydrogenated fats, fried meat and vegetables, addition of extra salt to meals at time of eating were frequent in two cities. While there was a higher consumption of bread, legumes, meat and candies in Qazvin, demands for nutrients such as rice, dairy products, fruits, fats and poultry were higher in Rasht. Daily calories intake>3000 kcal and consumption of macronutrients such as lipids>100gr, carbohydrates>550gr and proteins>100gr was more evident in Qazvin.
Conclusion: There were unhealthy dietary habits in two areas. No appropriate balance was seen between nutrients intake (low proteins, high fats and high carbohydrates). Correction of food habits and also more emphasis on nutrition education are recommended.
184NutritionThe effect of dexamethasone and high protein diet on protein metabolism in patients with head traumaHasani BarzySM.JavadiM. Solyman MaygoniS.152006101313502092008
Abstract
Background: Injuries and head trauma are considered to produce stress in patients which is accompanied with increased body catabolism reflected as higher secretion of urinary urea nitrogen.
Objective: To determine the effect of dexamethasone and high protein diet on protein metabolism in head trauma patients.
Methods: Through a clinical trial, 24 head trauma patients were randomly divided into two groups in which one group received dexamethasone three times a day plus high protein diet (study group), and the second group was given only high protein diet (control group) for 14 days. Determination of urea nitrogen content was carried out on 24-hour urine specimens collected before and after 14 days following the administration of high protein diet.
Findings: The excretion of urinary urea nitrogen was increased in case group whereas it was decreased (p<0.05) in control group. Howevevr, following the administration of high protein diet, the urea nitrogen content was reduced in both case and control groups and the reduction of this substance in control group was staticallysi gnificant.
Conclusion: Dexamethasone had no effect on improving the head trauma patients' conditions. Protein-rich diet caused a decrease in excretion of urinary urea nitrogen.
186NutritionThe effect of ascorbic acid on serum level of copper, zinc, ceruloplasmin enzyme activity and iron parameters in menTofighiM.AminpourA.KimiagarM.GloestaanB.152006101364302092008
Abstract
Background: Undue use of vitamin C has resulted concerns over some of the harmful effects of it.
Objective: To examine the effect of vitamin C on serum level of copper, zinc, iron parameters, and the ceruloplasmin enzyme activity.
Methods: This was a double-blind clinical trial carried out in 1999 in Iran Research Institute for Nutrition and Food Sciences in healthy men. Volunteers were divided into 3 groups. Ascorbic acid was given to first two groups at the concentrations of 500mg/day and 1000 mg/day, respectively. No ascorbic acid was delivered to the third group (control group). Fasting blood samples were collected in the beginning and at the end of the study period (6th week). Copper and zinc concentrations were determined by atomic absorption ceruloplasmin enzyme activity and vitamin C levels by colorimetric method iron, TIBC and hemoglobin by employing a kit from zist-chimi company and the percent of transferrin saturation was calculated using the formula: serum iron/TIBC×100. Dietary consumption pattern in the beginning and at the end of the study period were recorded using 24hr dietary recall questionnaire for one day.
Findings: Mean Blood ascorbic acid concentration increased by 67% (p=0.001), 76% (0.001), and 23% (p=0.04) in groups marked as 500 mg/day, 1000 mg/day ascorbic acid and control groups, respectively. This was statistically significant at the end of study. Mean ceruloplasmin enzyme activity decreased (p=0.004) in group 1000 mg/day ascorbic acid at the 6th week which was statistically significant. In spite of changes in serum copper and iron levels, these changes were not significant, statistically. Vitamin C had no effect on zinc concentration. No significant change was present in food consumption pattern during the study period.
Conclusion: Based on present data, vitamin supplementation at daily doses of 500 and 1000 mg cannot be recommended and further studies are needed in this regard.
187OphtholmologyClinical survey of ocular findings in patients with grave's diseaseRastegarA.BesharatiMR.ShojaMR.ManaviatMR.AhmadiehMH.152006101445102092008
Abstract
Background: Grave's disease is an autoimmune process manifested by three hallmarks: hyper-thyroidism with diffuse goiter, ophthalmopathy and dermopathy. This disease usually occurs with hyper thyroidism although the patients may be euthyroidism.
Objective: To evaluate the ophthalmic lesions in patients with grave's disease according to sex, age, and the duration of the illness as well as the treatment.
Methods: Ninety five patients (62% females and 38% males) with grave's disease were included in this study. The subjects underwent a complete ophthalmic examination and the results were recorded.
Findings: The elevation of IOP and chemosis were significantly higher in males than in females. The prevalence of ophthalmopathy was 60%, and most common ophthalmic signs were proptosis and lid retraction .Eye lesions were more frequent among 50-70 years old patients. In addition, chemosis, periorbital edema, corneal sensitivity secondary to dry eye, convergence insufficiency, diplopia and proptosis were positively correlated with age. Initially, ophthalmic complains were only given by 15% of the subjects. Lid retraction was decreased with prolonged duration of disease whereas chemosis, conjunctival congestion, and extra-ocular muscle enlargements were increased.
Conclusions: Grave's ophthalmopathy was found mostly in males and proptosis with lid retractions were the most important signs of the disease.
188AnesthesiologyThe effect of umbilical vein oxytocin injection on third stage of labor time and postpartum hemmorrhage MahaniIM.GhasemiA.GhaemS.152006101525602092008
Abstract
Background: Postpartum hemorrhage is one of the most important complications of delivery and is among the first five causes of maternal mortality and morbidity in developed and developing countries.
Objective: To investigate the effect of umbilical vein oxytocin injection on third stage of labor and degree of postpartum hemorrhage in primiparous women.
Methods: This study was down on 100 primiparas which admitted to labor department, Afzalipour hospital of in 2003 and had no history of bleeding tendency. According primiparas, age and demographic data they divided into study and control groups. Blood count was down before delivery. In study group 20 IU oxytocin in 20ml normal saline were injected in umbilical vein immediately after cord clamped. In control group 20ml normal saline were injected in umbilical vein. Placental delivery time, weight and number of used gauzes during the third stage, blood count 4 hours after delivery, sex and weight of newborn were recorded. The data was analyzed using T-student and mann-whithney tests.
Finding: No statically significant difference was found when patient age, gestational age, fundal height, newborn weight and sex, Hct, Hb and placental delivery time were compared in two groups. Postpartum bleeding in study group was less than in control group (141.82±91.6ml vs. 177.51±84.9cc) with a statistically significant difference (p=0.046). The difference in numbers of used gauzes was also significant (8.68±3.12 vs. 10.82±3.5), statistically (p=0.002).
Conclusion: Oxytocin injection into umbilical vein is an effective procedure to reduce the postpartum hemorrhage but has no remarkable effect on placental delivery time.
189Obsterics & GynecologyThe relation between third day FSH level and incidence of poor response in patients undergoing ART cyclesAshrafiM.Seirafi TehranianA.MalekzadehF.152006101576202092008
Abstract
Background: The number and the quality of oocyte are very important in ART cycles. The level of serum FSH on third day of menstrual cycle plays an important role in success of ART cycles.
Objective: To study the relation between third day FSH level and ovarian response in patients undergoing control ovarian hyperstimulation for IVF cycles.
Methods: This was an analytical study in which 2200 files from patients referred to Royan institute between 1991 and 1999 were examined. The study group included 212 patients whose serum FSH was measured for a maximum of six months before ovarian stimulation with long protocol GnRHa. Exclusion criteria included endometriosis and pervious treatment with ART. The patients were divided into two groups on the basis of third day serum FSH levels. Group I included 36 patients with FSH≥15IU/L and group II included 176 patients with FSH<15IU/L. The data (age, number of mature follicles, infertility duration, infertility type, and the levels of FSH, LH and progesterone) were analyzed using χ2, t-test and Fisher’s exact test.
Findings: There were statistically significant differences between two groups in the number of mature follicles (3.3±3.3 vs. 5.2±2.9, respectively), number of retrieved oocytes (4.5±7.75 vs. 7.0±5.5), number of transferred embryos (1.4±1.5 vs. 2.2±1.7), number of cancelled cycles (30.5% vs. 2.8%) and the level of serum LH (23.5±20.5 vs. 9±8.5).
Conclusion: The third day level of serum FSH can be relatively used as a predictor of ovarian reserve and success of ART cycles.
190Obsterics & GynecologyComparison of maternal risk factors in premature and term newborns Moghaddam EmamiME. MahyarA.KordiMH.152006101636602092008
Abstract
Background: Regarding the high number of births and the mortality rate of premature newborns, the identification of associated causes is necessary.
Objective: To compare the maternal risk factors among premature and term newborns in Qazvin during the year 2003.
Methods: In this case-control study, 120 premature and 120 term newborns were evaluated. Information such as blood pressure, history of eclampsia, cigarette smoking, maternal disease, and others were collected form newborn and their mothers using the medical files. The data were further analyzed, statically.
Findings: The results showed that 23 cases (19.2%) of premature mothers and 6 cases (5%) of mature mothers had eclampsia (P=0.001). twenty three cases (19.2%) of premature mothers and 5 cases (4.2%) of term mothers had multiple pregnancies (P<0.05). twenty five cases (20.8%) of premature mothers and 7 cases (5.8%) of mature mothers had history of dilatation and abortion (P<0.001). PROM was seen in 14 cases (11.7%) of premature mothers and in 5 cases (4.2%) of term mothers (P<0.05).
Conclusion: The results of this study showed that factors such as preeclampsia, multiple pregnancy, PROM, and abortion, play a role in increased number of premature newborns.
191MidwiferyCorrelation between passive smoker mothers and birth weight of infantsDelaramM.SereshtiM.152006101677102092008
Abstract
Background: Environmental tobacco smoke is one of the contaminating causes of air in closed areas and this can affect human fetus.
Objective: To detect the correlation between passive smoker mothers and birth weight of infants.
Methods: This was a descriptive and analytical study in which 440 parturient women participated. The cases were questioned during the first hours of their post delivery stay in Hajar hospital. Information such as age and height of mothers, number of pregnancies, weight gain in pregnancy, number of cigarettes smoked in presence of mother and also the birth weight of infants were all recorded. Statistical tools such as t-test, 2 and multivariate regression tests were used to analyze the data.
Findings: The results showed that 161 (36/6 %) of mothers were passive smokers. In this group, the mean of birth weight was 139 gr less than those from non smoker mothers (p<0/001). There was no significant difference between the birth weight and the number of cigarettes passively smoked, weight gain in pregnancy, number of pregnancies, age and the height of mother
Conclusion: In order to prevent the environmental side-effect of tobacco smoking, it is necessary to stop smoking in public places. Also educating the family members to avoid smoking during pregnancy and as part of pregnancy cares is of crucial importance.
192Obsterics & GynecologyPrevalence of HBsAg carriers in pregnant women in Qazvin (2000-2001)SharifiM.AsefzadehM. LalouhaF.Alipour HeydariM.EshtiaghB.152006101727802092008
Abstract
Background: Hepatitis B virus (HBV) is transmitted from various ways including mother to fetus. The rate of transmission from mother to fetus will also increase if both HBsAg and HBeAg are positive.
Objective: To determine the prevalence of HBsAg carriers in pregnant women in Qazvin.
Methods: A cross-sectional study was carried out on pregnant women who were visited in prenatal clinic of Kosar hospital and private clinics during 2000-2001, and referred to Qazvin transfusion center for laboratory examination. Blood samples were taken from all cases and analyzed for detection of HBsAg by ELISA. In case of positive test for HBsAg, the serum sample was assayed for presence of HBeAg. A questionnaire was used to collect other information. Statistical analysis was performed using Fisher exact test.
Findings: Study group consisted of 323 pregnant women, among them, eleven (3.4%) were HBsAg+ with no positive result for HBeAg. Positive HBsAg showed a significant relationship with hepatitis history (p<0.001), history of hepatitis in relatives (p=0.033), background diseases (p=0.028), and the history of addiction in partner (p=0.034). No significant relationship was found with other risk factors such as (history of abortion, dental operations, transfusion, traveling aboard, first pregnancy, contraception, and second marriage).
Conclusion: In cases of significant risk factors (history of hepatitis in pregnant women or their relatives, background diseases, and the presence of addiction in partners), screening test has special necessity. We recommend retesting of high risk pregnant women in their 3rd semester whose primary tests are negative.
193PediatricsFrequency of hospitalized cases of mumps in Qazvin (2002)BarikanyA.152006101798302092008
Abstract
Background: Mumps is a viral infection. Although the disease is usually mild, up to 10% of patients can develop aseptic meningitis.
Objective: To study the frequency of hospitalized cases of mumps in Qazvin.
Methods: This was a cross-sectional study in which the cases with mumps and admitted to two pediatric hospitals were investigated in 2002. Information on demographic status, history of vaccination, signs and symptoms of disease, side effects of disease and also the cost of hospitalization were collected. The results were analyzed using SPSS software.
Findings: There were 204 cases of clinical mumps reported in 2002. Seventy seven percent of cases were male and 23% female. The mean of the patients' ages was 7.6+1.4. A history of contact was found in 45.5% of cases. The most common symptoms were vomiting (86.5%) headache (64.3%) and abdominal pain (31.3%). The benefit-cost (BC) of vaccination ratio was 1.6.
Conclusion: The immunization program is a cost effective protocol and will be economically more beneficial if a combined vaccination including mumps, measles and rubella to be used.
194Occupational Health EngineeringٍNoise induced hearing loss and its relationship with dose and exposure length Ghorbani Shahnaf.152006101848802092008
Abstaract
Background: Noise Induced Hearing Loss (NIHL) is an important occupational disorder and the protection of workers against noise is essential.
Objective: To ‏ evaluate the noise induced hearing loss and also presenting a statistical model based on effective variables such as the duration of employment and dose of received noise.
Methods: ‏This study was carried out on workers of a cleaners manufacturing industry. The study group composed of 209 subjects who were selected out of a total of 400 workers. The hearing loss was measured after rejection of age related loss. Following elimination of the effect of ear protective device, the dose of pure received noise for each subject was determined.
Finding: The results indicated that the noise pressure level in different parts of the manufacturing unit was 76-107 dBA. The mean of employment duration, dose of pure received noise and total permanent hearing loss were 9.96.9, 135.411.51, and 12.524.1, respectively. The regression analysis of results showed that there was a direct and positive correlation between permanent hearing loss, dose of noise and the duration of employment (r=0.84,r2=0.77). This was a significant correlation for both right (r=0.77, r2=0.6) and left ears (r=0.8, r2=0.64). The survey of hearing loss in both ears showed that the hearing loss in left ear was greater than that in right ear. Regarding the data obtained in our study, models for calculating the either, left or right hearing loss, were recommended by determining dose and the duration of employment in study group.
Conclusion: Considering the NIHL, the necessity for improvement of controlling and protection measures is of prime importance.
195Environmental Health EngineeringA study on relationship between the atmospheric quantity of heavy metals and PAHs in the city of IsfahanLoloeiM. BinaB.alebiM.152006101899402092008
Abstract
Background: Heavy metals are toxic and polycyclic aromatic hydrocarbons are known as toxic, carcinogenic and mutagenic compounds.
Objective: To determine the concentration of PAHs and heavy metals in sample and the relationship between these two pollutants in the atmosphere of the city of Isfahan.
Methods: In present study, air particulates were collected on glass fiber filters by using a high-volume air sampler. Flow rate and sampling period were 0.5m3/min and 12 hrs, respectively. Each filter was exactly cut into two equal pieces. One piece was digested with HNO3 and H2O2, and the second piece was extracted with DCM, using soxhlet method. The later was used for determination of PAHs.
Determination of heavy metals concentrations were performed using a Perkin-Elmer atomic absorption spectrometer. The concentrations of PAHs were measured using a PU 4400 gas chromatograph equipped with a FID detector.
Findings: The concentration of lead was higher than other metals (748.5 ng/m3) however it was lower than the standard value (2000 ng/m3).The extraction efficiency of PAHs with soxhlet method was 92-100 percent. The concentration of Benzo (α) pyrene, index of aromatic hydrocarbons, was 2.72 ng/m3. PAHs concentration in non-working days was lower than working days of a week. Correlation coefficient between PAHs and heavy metals was 0.9 (P<0.005). The changing pattern of heavy metals and PAHs was closely similar.
Conclusion: The concentrations of PAHs and heavy metals were determined in different samples. The relationship between the atmospheric concentrations of PAHs and heavy metals was investigated and an excellent agreement was found.
196Occupational Health EngineeringSusceptibility of cockroaches to Lambadacyhalothrin and Cypermethrin in hospitals of Tehran University of Medical Science BaniardalaniM.NourjahN.ChanganiF.1520061019510002092008
Abstract
Background: Regarding the high exposure of cockroaches to insecticides in hospitals, the chance for development of resistance is increasing.
Objective: To determine susceptibility of different strains of Belattella germanica L. to Lambadacyhalothrin and Cypermethrin insecticides.
Methods: The strains were collected from 5 hospitals affiliated to Tehran university of medical sciences (Emam,Dr. Shariatii, Markaz e tebi, Ziaeian, Baharlou ). Susceptibility tests were carried out on 1-3 days nymphs according to WHO standard method in different time.
Finding: Susceptibility tests on 1-3 days nymphs indicated that the strains of German cockroaches collected from hospitals mentioned above were all resistant to Cypermethrin and also with some susceptibility changes to Lambadacyhalothrin.
Conclusion: The resistance observed in our study may be due to current use of insecticide for German cockroach control and hence the development of cross resistance to these insecticides.
197Health Care ManagementJob motivators from the employees and managers' point of view in teaching hospitals affiliated to Qazvin University of Medical SciencesRaeissiP.MohebbifarR.15200610110110802092008
Abstract
Background: Being responsive to employees' needs and recognizing their job motivators is one of the most important tasks of the top managers in any organization.
Objective: To determine the most important job motivators from both employees and managers' point of view in teaching hospitals affiliated to Qazvin University of Medical Sciences.
Methods: 300 out of 1379 employees and 96 managers of teaching hospitals were evaluated in the period of 2002-2003. A multistage sampling was used to select the employees but no sampling procedure carried out on the managers. The data were collected through a self-report questionnaire. Lindahl's Job Motivators Inventory (1949) was used to determine the most important job motivators. Ten extra questions were added to the employees' questionnaire to measure their job satisfaction as well. These questions covered the same concepts as in the Lindahl's Job Motivators.
Findings: The results revealed that parameters such as "adequate salary", "suitable working condition", and "job security" were the first three important job motivators from employees' point of view. Managers however, ranked the most three important job motivators as "adequate salary", "job security", and the "suitable working condition", respectively. The findings also indicated that 4.2% of the employees were satisfied with their job, 30.3% dissatisfied and the rest (65.5%) semi-satisfied. In correlating "job satisfaction" questions with "Lindahl's Job Motivators Inventory" in an item to item fashion, a negative relationship was found between the ranking of "suitable working condition" and "satisfaction with current job condition" item (p<0.05). This implied that, as the satisfaction with working condition decreased, the ranking of the relevant item on Lindahl's Inventory increased.
Conclusion: The personnel were highly concerned with the physiological and safety needs according to the Mazlow's hierarchical need model and their superiors were aware of such needs.
198Health Care ManagementPerformance of production factors in general hospitals affiliated to Iran University of Medical Sciences RezapoorA.HaghparastH.15200610110911402092008
Abstract
Background: For the purpose of optimal utilization and boosting the productivity of resources, hospitals as economic firms must use economic analysis.
Objective: Assessing the performance of production factors in general hospitals affiliated to Iran University of Medical Sciences (1991-2001).
Methods: This was a cross-descriptive study carried out in 2003. Information sheets were used to gather the data, which were further analyzed using Eviews software and SuR statistical test.
Findings: Production elasticity of physicians, nurses, active beds, and paramedical personnel were 0.57, 0.33, 0.24, and -0.07, respectively. Arerage length of stay and subjective variables had an effect rate of -0.188 and 0.47 on hospitals' production, respectively. All production factors showed positive values of marginal product except for paramedical personnel and there was increasing return to scale in target hospitals.
Conclusion: All production factors were in economic region of production and had optimal performance except for paramedical forces. Thus, in order to boost the total product, an increase of all factors except the paramedical personnel, is recommended.
199Community MedicineUse of Geographical Information Systems in epidemiologyRezaianM.15200610111512302092008
Abstract
Geographical Information Systems (GISs) are the automated systems for the capture, storage, retrieval, analysis, and display of spatial data. These systems have significantly increased the ability of epidemiologists and public health specialists to work with spatial data. When GISs are combined with spatial analytical methods, the results could provide a helpful tool in the study of public health issues. Nevertheless, the users of GISs and the readers of the output should not study the attractive maps produced by the software uncritically, but should always remember the rules of good data management, analysis, presentation, and interpretation. The present article therefore, discusses the pros and cons of a GIS environment in public health and epidemiological studies.
200Health Care ManagementHow Knowledge Management (KM) can be applied to healthcare organizations?PiriZ.AsefzadehS.15200610112413202092008
Abstract
Information and its increasing effective use in decision making has caused the emergence of KM. The core reasons leading to emergence of KM are: (1) The shift from the dominancy of tangible assets era to intellectual capital era, (2) The dramatic increases in the volume of information, its electronic storage and increased access to information in general, and (3) The demographical changes accompanied with the danger of losing people through retirements. Initially, information technology departments were the focus of KM initiatives, however, as the focus moved to people's expertise, other departments became increasingly involved. Six strategies have been offered as KM strategies. These are the Knowledge Strategy as Business Strategy, the Intellectual Asset Management Strategy, the Personal Knowledge Asset Responsibility Strategy, the Knowledge Creation Strategy, the Knowledge Transfer Strategy, and the Customer-Focused Knowledge Strategy. To find theoretical concepts of KM and its applicability in healthcare organizations, different knowledge management-associated journals such as the Information Research and the Knowledge Management Practice journals, published since 1990, were examined. Search engines such as the Science Direct and the Emerald were also used for hunting internet sources.
201PathologyCongenital pouch colon with imperforate anus A report of 3 casesSadeghipour RoodsaryS.HiradfarM.ZabolinejadN.AlamdaranSA.15200610113313602092008
Abstract
Congenital pouch colon (CPC) is an unusual condition in imperforate anus (IA), usually of high variety. This malformation is mostly reported from India, where it comprises about 7% of all anorectal malformations. In this anomaly, the normal colon is very short or absent and is replaced by a pouch like dilatation that usually communicates through a fistula with genitourinary tract or persistent cloaca. We are reporting on three cases of newborns (2 females, and 1 male) with this anomaly diagnosed during September 2001 to September 2004. These three cases comprise less than 3% of all cases of IA during this time period. The two girls had anorectal agenesia, short segment of colon and a pouch with vaginal fistula and persistent cloaca (Type II). Colon in the third case was replaced by a dilated pouch that communicated with a wide fistula to the bladder (Type I). This is very important for pediatric surgeons to be aware of the features of this condition to allow for proper diagnosis and surgical management.